Donald Trump has signed 109 executive orders since his return to the White House. Many of them have aimed to erase protections for transgender and non-binary Americans.

One of the earliest was a Jan. 20 document, which recognized only two biological sexes: male and female. It directed numerous federal agencies and federally funded entities to end existing accommodations for people who exist outside that binary. Government officials have responded quickly to this and other subsequent executive orders, overhauling health care access for trans veterans and military members and passport guidelines, among other policies.

This flurry of executive actions — and lawsuits challenging them — have made it increasingly difficult to understand the rights that remain for trans and non-binary people. Harper Seldin, a senior staff attorney with the American Civil Liberties Union, said it's key to remember that state law can offer additional protections that federal law does not. The Pennsylvania Human Relations Act, for instance, prohibits discrimination in employment, housing, commercial property, education and public accommodations based on sex, race or religion. The category of "sex" includes gender identity.

"It's important that medical institutions and other folks who are covered by the PHRA in Pennsylvania know that whatever they decide to do, they're also subject to Pennsylvania law," Seldin said.

Here's what the landscape looks like for transgender and non-binary people in Philadelphia, based on insight from legal experts, resources and actions pending before federal courts:

Can I still receive gender-affirming health care?

Prominent hospitals across the country began canceling health care appointments in the wake of Trump's executive order restricting gender-affirming services for transgender patients under the age of 19. Representatives for the Children's Hospital of Philadelphia, Temple Health, Penn Medicine, Jefferson Health and the Mazzoni Center would not say whether their services had changed in response to federal directives. 

But Seldin said the ACLU had received reports of gender-affirming health care appointments being cancelled in Pennsylvania. Patients can submit complaints through a number of channels, he said, including the doctor's office or hospital, Pennsylvania Human Relations Commission, Pennsylvania Office of Attorney General, Lambda Legal and the ACLU.

"They could also advocate within their communities to find resources for hospitals and doctor's offices that are continuing to provide care," Seldin said.

What if I'm a veteran or member of the military?

The Department of Veteran Affairs is still offering hormone therapy to patients who were already receiving treatment as of March 17. But it has ended gender-affirming medical services for all new patients. The department made the change in response to Trump's Jan. 20 executive order.

This policy extends to the Philadelphia VA, which operates a medical center at 3900 Woodland Ave. While its website listed hormone therapy, gender-affirming prosthetics and psychosocial assessments for those services as recently as March 27, that information has since been scrubbed. Rita Chappelle, chief of media and outreach for the Philly VA, said the page had been "out of date."

Care for LGBTQ+ veterans in Philly is now limited to mental health services, creative arts therapies, HIV and STI testing, counseling and medication (i.e. PEP, PrEP) for those at risk of HIV and other prevention and wellness services.

The Department of Defense canceled any planned gender-affirming surgeries for active service members in a Feb. 26 memorandum. That document also made a history of hormone therapy grounds for dismissal from the military, though it stipulated that patients could continue this medical service on a doctor's recommendation "until separation is complete." 

This memorandum — and the Jan. 27 executive order that spawned it — was blocked by a federal judge on March 27. The Department of Defense did not immediately clarify whether gender-affirming health care was currently available to service members.

"As a matter of policy, the Department does not comment on ongoing litigation," the agency said.

Can I still get my name or gender changed on legal documents?

Pennsylvania residents can update the name or gender marker on their driver's license by submitting the appropriate form to the Department of Motor Vehicles. To alter the name on a license or photo ID,  bring a completed application to a PennDOT Driver License Center. There is no fee, but a certified copy of the court order approving your legal name change is required. Applicants can update the gender marker on their license or photo ID — choosing between "M," "F" or "X" — by completing DL-32 and bringing it to a PennDOT Driver License Center.

Birth certificates issued in Pennsylvania can also be amended. Applicants must mail a request, along with a photocopy of their ID and $20 check or money order, to the state health department

Passports are a trickier matter. The State Department is no longer offering an "X" marker on these documents, and will only allow gender designations "that match the customer's biological sex at birth." The policy was implemented shortly after Trump's Jan. 20 executive order, which directed the State Department to change its guidelines and require government-issued documents "accurately" reflect the holder's sex.

Passports issued prior to this shift are still valid until their expiration date. For this reason, Lambda Legal advises transgender and nonbinary travelers to hold off renewing their passports — or applying for a new one — unless necessary.

A lawsuit challenging the new guidelines for gender markers on passport is pending before a federal court in Boston.

The Social Security Administration has also allegedly stopped processing requested changes to gender markers on its cards.

Can my kid use their preferred pronouns and bathroom at school?

The School District of Philadelphia recognized the right of students to be addressed by a name and pronouns that match their gender identity in a policy adopted in 2016. That guideline also directed staff to provide students access to bathrooms and locker rooms that match their gender identity; kids who request extra privacy for whatever reason are given access to a single-stall restroom. 

Policy 252 is still in effect as of March 2025.

"The School District of Philadelphia strives to ensure safety, equity and justice for all students regardless of gender identity or gender expression so that they can imagine and realize any future they desire," Christina Clark, communications officer for the school district, said in an email. "The District will continue to align its practices to support its LGBTQ+ students in accordance with Board Policy 252 for transgender and gender non-conforming students."

Can I compete on a team matching my gender identity?

The Trump administration issued another executive order targeting transgender athletes on Feb. 5. This directive instructed the government to rescind federal funds from schools that allowed trans women to compete in women's sports. The NCAA changed its policy the next day, restricting participation in collegiate women's sports to "student-athletes assigned female at birth only." 

The changes brought renewed scrutiny to the University of Pennsylvania, where transgender student Lia Thomas competed on the women's swim team. Thomas won the women's 500-yard freestyle at the NCAA Division I championships in 2022, becoming the first transgender athlete to claim a title at the competition. Three other former Penn swimmers sued the school over Thomas's inclusion on the women's team, citing Title IX violations. The Trump administration later stripped the university of $175 million in funding over its trans athlete policies.

There's a bit more freedom in Philly's K-12 public schools. Policy 252 stipulates that students in the School District of Philadelphia are allowed to participate in intramural sports and gym classes "in a manner consistent with their gender identity," though participation in competitive athletic activities is determined on a "case-by-case basis."

"The most important thing right now for trans people, I think, is to be in community with each other," Seldin said. "Because I do think that a lot of us are going to be facing instances where we are told that this is a space that we don't belong in, or this is something that we cannot do because we are transgender. So I would encourage students who find themselves in positions like that to organize with each other, to find other organizations and adults in their community who support them and to continue to remind folks that they are people who need to be loved and feel safe in their communities as well."

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